Have a High Screen Time? Here’s How It Can Affect Your Eyes

The amount of time that people spend looking at screens — whether it be their phones, computers, or tablets — has skyrocketed in the past decade. With this has come a rise in the number of people experiencing “digital eye strain,” a condition that can affect people of any age and may worsen over time if not addressed.

As an instructor at the University of Colorado Anschutz Department of Ophthalmology and an optometrist at the Sue Anschutz-Rodgers Eye Center, Melanie Akau, OD, has witnessed firsthand the increasing prevalence of digital eye strain and its negative effects on patients.

“Computers aren't going away, and we’re still learning what the long-term consequences are of extensive screen time,” she says. “That’s why trying to help resolve the issues patients are experiencing is very important.”

We recently spoke with Akau, who also serves as medical director of staff education at the eye center, about digital eye strain, its effects on patients, and the steps she and her patients can take to help reduce or resolve their symptoms.

The following interview has been edited and condensed.

What is digital eye strain, and what are the common symptoms of it?

In general, digital eye strain refers to a group of symptoms related to the eyes and/or vision that worsen as you look at screens, such as a computer, iPad or tablet, or smartphone.

Symptoms of digital eye strain may include blurred vision, headaches, eyes feeling heavy, needing to blink a lot, and feelings of eye irritation, grittiness, dryness, burning, or fatigue. Sometimes, it can be difficult to distinguish these symptoms from other eye issues or conditions. In general, digital eye strain can exacerbate ocular surface disease, such as dry eyes.

As an optometrist, how do you approach helping patients who may be experiencing digital eye strain?

Part of my work focuses on glasses prescriptions and optimizing vision, and the rest on medical eye care. I like to ask patients about their computer setup, if they use a laptop or computer monitor, how many monitors they have, and where their monitors are placed. How far away a patient sits from their computer screen, and associated tasks they perform, can also affect the type of prescription they get. I also ask if they wear multiple pairs of glasses and whether they have specific computer glasses.

For patients who wear bifocal or progressive lenses, when using a screen, they may have to tilt their chin up and look down through their glasses to be able to see the screen. This can create a lot of neck and shoulder pain. They may not know there is an option to have a different set of glasses made that specifically gives them a great field of view for their computer screen, though it does come with the cost of a second pair of glasses.

If a patient reports having headaches and eye strain, I’ll assess if they have eye alignment issues that may be overstraining their focusing system or the alignment of their eyes. This might lead to us looking at different types of glasses prescriptions to help them. If a patient reports feeling burning sensations in their eyes, then that may indicate that they need dry eye or ocular surface treatments. Sometimes, a patient may need both interventions, and during an exam, I will assess them for both options.

Can digital eye strain lead to a person needing glasses?

It is not the norm, but extensive screen time can lead to a patient needing a glasses prescription that they otherwise would not have needed.

In general, if a person is consistently looking at a screen that is 2 feet from their face for long periods of time, it creates a lot of strain on the eye’s focusing system. The focusing muscles of the eye typically change as we near our 40s and 50s and results in people needing reading glasses. Now, we’re sometimes giving reading glasses to people earlier in their lives to help support that delicate system.

How common is digital eye strain?

It’s very common, and it’s now occurring more frequently in patients in their 20s and 30s. A lot of younger patients have great distance vision, but now that they’re on computers for a long time, it introduces a level of strain that we likely didn’t have in the past.

Blue light glasses are heavily marketed as helping protect the eyes from screens, but their effectiveness is debated. What are your thoughts on them?

The evidence is unclear. There have been reviews stating that there may be no benefit to blue light filtering glasses for decreasing eye strain in the setting of computer use. Anecdotally, I’ve had some patients get them and say that it helps with their eye fatigue. Other patients have noticed no difference.

Ultimately, it’s up to the patient and does not appear to cause any harm. For patients who wear glasses, I recommend getting an anti-reflective coating to help decrease glare from screens.

Some Apple devices have a “screen distance” feature that alerts users when their device is closer than 12 inches to their face for an extended period of time. Could that be a helpful tool for reducing eye strain?

The closer we hold anything to our face, whether it’s a screen or a book, we are asking more of the convergence and focusing system. For some patients, this can cause additional stress, whereas for our nearsighted patients who can read up close without their distance glasses on, it is not taxing on their system. So, this is an interesting feature that might be helpful in some cases, and not as helpful in others.

Overall, what do you recommend people do to best protect their eyes?

Taking breaks from screens is important. The 20-20-20 rule can be helpful, where for every 20 minutes you spend looking at a screen, we recommend looking at something that is more than 20 feet away for at least 20 seconds. That allows the focusing system of your eyes to rest and relax.

Blinking is also a simple but important step. We don’t blink as much when we’re staring at something up close, and when we do blink, unbeknownst to us, our eyes may not be closing all the way. This is essential because blinking helps move our tears over the surface of our eyes, and those tears have a lot of nutrients. Lubrication drops may also be helpful.

It’s also important to go to your regular eye exams, and if you are experiencing any of these symptoms, bring it up to your eye specialist — even if your vision is perfect. Optometrists and ophthalmologists are well versed in ways to mitigate digital eye strain.